This application of the Comprehensive Cancer Center of Wake Forest University (CCCWFU) requests renewal of its Cancer Center Support Grant for Years 33 through 37. During the current grant period, peer-reviewed annual direct cancer funding increased from $10.8 to $25.4 million, NCI funding increased from $5.1 to $12 million, and annual direct funding per member increased from $106,000 to $233,000. Interprogrammatic publications increased from 9.1% to 11.8%, intraprogrammatic publications increased from 16.7% to 28.6%, and interdepartmental publications increased from 17.4% to 28.7%. Formal collaboration (co-investigators, consultants, or collaborators) with other Cancer Center members is present on 68.5% of peer-reviewed research grants listed in summary II. In the current grant cycle we have made few structural changes, and instead focused on the execution of our scientific vision. Support is requested for four Programs: Cell Growth and Survival, DNA Damage and Cellular Defense, Clinical Research and Cancer Control as well as seven shared resources: Biomolecular Resource Laboratory, Cell Culture and Viral Vector, Microarray, Cellular Imaging, Tumor Tissue, Biostatistics, and Clinical Research Management. During this funding period, the CCCWFU opened a new 225,000 sq.ft. outpatient cancer center, and continued its longstanding focus and unique contributions to the cancer problems in our 7 state catchment area. The blueprint for our next five years is embodied in this application, which provides the Center's vision of how it can reduce the burden of cancer in our region and in the nation.